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BETWEEN
YESTERDAY AND TOMORROW
by Col. Michael R. Davis, Lt. Col. David S. Johnston
and Mr. Ramin A. Khalili
I
t wasn’t that long ago when the concept of the future—
this time beyond time, this collection of years on the
horizon somewhere—was just that, a simple concept. But
as we move from Operation Iraqi Freedom (OIF) and
Operation Enduring Freedom (OEF) onto a newer and more
complex version of the battlefield, the future is beginning to
look increasingly familiar—more and more like a direct reflec-
tion of the past.
Given that a more confined and condensed combat zone will
likely be the norm for future conflicts, we can no longer afford
to operate as a strictly reactive medical force, simply waiting to
respond to geopolitical changes and technological advances.
Instead, we must build upon what we know right now, refining
our tools and tactics along the way.
This is how you stay ready. This is how you save lives. This
is how you win.
With that mindset, it seems appropriate to explore the ways
that we at the U.S. Army Medical Research and Materiel Com-
mand (USAMRMC) Combat Casualty Care Research Program
(CCCRP) are continuing to modernize in the face of global
instability and potential military intervention—all with a focus
on sustainment of the modern warfighter.
BLOOD: THE BATTLEFIELD NECESSITY
Modernizing can mean looking to the past to revitalize highly
effective—but often lost—treatments, and blood products offer
the perfect example. During the recent “throwback ” efforts
to modernize (during OIF and OEF) via the use of whole
blood instead of crystalloid and other synthetic products, new
advances in blood technology have been greatly accelerated. Of
these advancements, freeze-dried plasma (FDP) remains the
most potent tool because it can be brought to the Soldier on the
battlefield instead of requiring evacuation to a medical facility.
The benefits of FDP—which is essentially a bloodlike substance
minus the red blood cells—are many, but chiefly include its por-
tability, its lengthy shelf life and the fact that it can be quickly
reconstituted with sterile water at any time. While all special
operations units deployed to war zones now carry FDP kits as
a matter of protocol, approval for wider use by the U.S . Food
and Drug Administration (FDA) is likely several months away.
Full-throttle production is shortly behind that approval and
dependent upon blood collection efforts.
Meanwhile, the FDA has been an important partner in likewise
advancing cold-store platelet technology, a method in which
platelets are removed from donor blood, stored at refrigera-
tor temperature and then inserted back into the patient to aid
clotting and to help minimize blood loss. Those efforts, which
in 2015 resulted in a landmark extension of platelet shelf life
USAMRMC’s Combat Casualty Care Research Program
pursues evolving medicine for an evolving battlefield.
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SCIENCE&TECHNOLOGY